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Today I find myself in the same spot I was a few months back. Tomorrow I take the final exam in Advanced MedSurg for the second time, and for the second time it all comes down to this test. It’s very simple: pass the final, pass the class. No other way around it.

Everything is riding in this exam. It’s not just the class, but also my continued attendance at MDC School of Nursing, since I can only retake a class one time and that’s it.

It’s just about the end of the first half of the semester, the end of Advanced MedSurg, and I am wiped. You may see me up and about doing stuff (I try to do my best around the house even if it isn’t a lot) and studying (not today Friday, but seriously, I’ve never studied this hard ever before) and working out (I’ve been running regularly for the past three weeks), but I am beyond depleted. If I had a little battery icon like my phone, I would be in the red.

The sad thing is that I’ll get to sleep tonight and tomorrow during Shabbat, but it won’t really help. Yes, I’ll feel somewhat refreshed and renewed, but in light of the two days after, during which I need to finish studying an entire semester of Advanced MedSurg for my final on Tuesday and ATI (standardized) test on Wednesday, it will simply be a like bandage on an arterial bleed.

Still, I have no option but to continue ahead and hope copious amounts of coffee will be enough to give me energy and focus.

I was hoping that this post would come in mid-December, but that was not to be. As I mentioned in my last post, I was barely scrapping by in Advanced MedSurg, with my chances of passing resting on two exams on the final week of class. I took both, and the combined scores left me below the cut-off point for a C (which in Nursing is a 77/100). So Friday afternoon, home after the final exam, exhausted from non-stop studying over the past week, I got the email from my professors that confirmed I had not passed the exam, and therefore failed the class.

It was like a punch to the gut.

I’m feeling better about it now. I’ve gone through the five stages of grief and accepted that there’s nothing I can do about it now, so I need to move on. It sucks, yes. I’m not used to failing, and I had to fight hard not to let an overwhelming feeling of worthlessness overtake me. But I’m good.

Today I met with my professors, discussed the situation, and made plans for the future. The paperwork still needs to be processed on the administrative end, but I will be joining the next session of Advanced MedSurg, in January, which will put me on track to finish my Nursing degree in March. So it’s not so terrible, it’s not like I have to wait another six months for the upcoming Accelerated Option class. I did pass my Advanced MedSurg Clinical, so there’s that silver lining.

In the meantime, I suddenly find myself with lots of time once more. I am putting together a plan of action that will structure my days off, so I don’t get too rusty, but I’m also going to rest and recharge, and do some of the stuff I have neglected due to school, like writing.

I haven’t written about what’s going on in my nursing classes since the end of the Spring semester. I’ll have to do that at some other point, though in short, it was an interesting mix of Nursing specialties and I did fairly well.

Right now, however, I find myself in the same spot I did back in Spring in relation to the first part of Medical-Surgical Nursing: I am on the very edge between passing and not passing (I got an F on the first exam [long story], and a C on the second exam), and all rests on the final exam.

It would suck to fail Adv MedSurg at this point, since it is the next-to-last class in my year-long program; it isn’t something I want, nor want to think about too much, but it is something I have already considered. It isn’t the foremost thought in my mind, however. I am still in the game, and with a really good grade it is possible for me to pass this class and move on to Leadership, the last class before graduation.

That message in the meme picture above? That is my mantra for the next week.

I’m studying for my MedSurg final and I remembered this incident that happened last week during clinicals.

My patient was very stable and compliant that day, so after doing my assessment and morning care I went to check with my assigned nurse to see how else I could help her. We saw all her other patients and then I tagged along while she gave meds, which gave me a chance to review desired and side effects as we went along.

One of her patients was a middle-aged man with severe wrist swelling. As she prepped his meds, I would tell him what he was taking and some side effects to watch out for. For one of the meds we had to check his sodium level, which at the time of his last labs was 131, slightly under normal (135-145 mEq/L). As I applied a topical gel to his wrists to help with the pain, he asked us if he was scheduled for a brain scan that day. The nurse and I looked at each other, a bit confused by his question. She said that there was nothing in his chart about a brain scan. I asked him why would he have a brain scan and he said he’d been having extremely vivid dreams for a while, the type where you don’t know if you’re awake or asleep. The nurse said she’d check again to be sure and I filed away this information.

As I went on about my duties, I kept thinking about this patient and his question. Something in his case was triggering memories in my head but I quite couldn’t put my finger on it. It hit me about an hour later, while I was helping my patient back to bed after she had eaten her breakfast and I saw the slip on her tray that said “Cardiac Diet” (which means no more than 2g of sodium a day).

The Accelerated Option nursing program has a weird schedule that doesn’t exactly match the regular academic year at Miami Dade College. That said, last Friday was the end of the Spring Semester, and that brought the end of two of the four classes I was taking since March. How did I do?

Nursing Medical-Surgical Skills: A

Pharmacology: C

I am extremely happy with my grades for this past semester. That C in Pharmacology? I sweated that C! We had a terrible time with that class due to having a really bad “teacher” that was simply not interested in teaching us the material. We mostly learned it all on our own, and with the help (finally at the end!) of our other professors. So yeah, a C there was gold, because it means I passed, and that’s what I needed.

I am still taking Medical-Surgical Nursing and Clinicals for another month, so I’ll update those grades when I get them.

Just so you get an idea of the speed at which my program moves: I am writing this on March 11, a Sunday, and already I am one week into the second semester and one week away from my first exam. No time to breathe!

Anyway, on Friday, March 2, I finished my first semester of Nursing School and I did really well!

Nursing Fundamentals: A

Adult Health Assessment: B

Introduction to Pharmacology (Math): A

Nursing Fundamentals Skills: A

Nursing Fundamentals Clinical: Pass

It feels like I’ve been in school forever, but it’s only been two months. Two really hard, challenging months. I’ve gone from being a naive enthusiastic student with absolutely no practical knowledge of nursing, to an apprentice, enthusiastic student with the fundamental skills and knowledge of nursing. I’ve already helped patients on the floor at a nursing home and at the hospital, not to mention at an accident and during a potential emergency. I’ve given medications, I’ve redressed wounds, given bed baths, changed beds, cleaned whatever needs to be cleaned, been yelled at by a hooped-up-on-narcotics patient, gotten to know patients well enough for their families to recognize me out on the street and for me to wonder about them and their status in the days in between clinical rotations.

I’ve already studied far more than I ever thought I would, and realized it’s not enough; I’ve already felt like I have learned nothing and I’ve wasted time and money because I’ll never be able to do this right; I’ve already cried for no particular reason simply because of stress; I’ve lost so many hours of sleep that I simply don’t think I will ever catch up. And I’m only two months into my education.

And I friggin love it.

I had one weekend of freedom, and already the second semester has started. I am now taking Medical-Surgical (Med-Surg for short) Nursing Lecture, Skills and Clinicals, and Pharmacology. Bring it on.

The thing about being a nurse, even a student nurse, is that you see so much suffering and so much that could go wrong that it puts everything into perspective. You stop complaining a lot about little things, appreciate your health over money, and want to smack people over the head when they whine needlessly.

Seriously. I had been told this by my nurse friend, but I was surprised how quickly it kicked into effect on me. I still bitch about little things, I still complain about being broke, and I still whine needlessly from time to time, but I know I’ve been doing it less and many times I just keep it to myself. Because I’ve seen glimpses of the bigger picture, and you know what, I have very little, if anything, to bitch about.

(With apologies to those who already read part of this when I posted it to Facebook and Twitter.)

January is over, which means I’ve survived the first month of this year-long crazy train that is the Accelerated Option program. In one month I’ve gone from being a newbie with no actual Nursing knowledge to having the rudimentary skills necessary to be thrown into a clinical rotation at a nursing home and be expected to not hurt anyone.

January has been tough. Getting used to the new academic methods used in nursing, the constant studying, the sheer amount of information being thrown at you, all of these have been tough on me. But I’ve survived. Mostly. I’ve already had two nervous breakdowns, one at the start and one at the end of the month, so it seems I’m right on track, based on what my nurse friends have told me. But you know what? I’m loving it.

In this first month I’ve had five examinations:

Nursing Fundamentals Skills: Passed.

Nursing Fundamentals Lecture exam: A

Nursing Assessment quiz: A

Intro to Math & Pharmacology exam: still waiting

Nursing Assessment midterm: still waiting

I should have the grades to the last two this coming week, when I will also have my midterm in Fundamentals Lecture. Yeah, we go that fast.

This past week was also my first week of clinicals. My group is doing two visits a week at the Villa Maria Nursing Center in North Miami Beach. Our first day was all orientation, but on the second day we got divided across the various wings and assigned to the CNAs (Certified Nurse Assistants) on the floor. I ended up changing the bedding on a few beds, seeing the wound care nurse change dressings on a few nasty wounds, and giving a bed bath to an almost-total-care patient. Didn’t have to deal with poop on my first day, though I know that won’t last.

It was a humbling experience, really. I knew I knew my material, and then it seems I forgot it all when we were on the floor. But then as we did things, it all came back and I was fine. It was emotionally charged, and during our post conference various students broke down as well. I don’t think you can be a nurse and not go through this process; you’d be heartless, otherwise, and you can’t be heartless as a nurse. Tough, yes, but not heartless. I can’t wait to go back there this week.

Over the last two weeks of Nursing school something has been made very clear to me: my brain is wired in a very particular way. Let’s call it English (as in English Major) way.

My natural tendency, honed by the training of an English degree, is to absorb content, then look for concepts and ideas embedded in that content. I read sentences and my mind automatically takes notice of the length, the word choice, the rhythm. Is there a reason for the flurry of short sentences? Why are there all these semi-colons here? Why this word instead of a more common synonym? This is how my mind works with the written text.

With other media, be it visual or auditory (including class lectures), I primarily absorb rather than notate. Even during my science classes during my Pre-Nursing time, I would mostly listen and observe the lecture, making notes in a rather automatic manner, as the audio/visual data was far more important for me. This info then percolates in my head and gets absorbed into practical applications. I may not be able to parrot it all back, but the info is there and I can recall it when it is applicable.

The thing is, the English brain wiring is not gonna cut it in Nursing school.

When I read my text books, there is no subjectivity to the written word: the author meant this, period. As my friend Christina put it, “You can’t read into and/analyze board questions! It is what it is! That’s your new mantra.” And she’s right. I’m not in English anymore, I’m in Nursing.

This isn’t to say that all my previous skills are useless. There is room for critical thinking and analysis in Nursing, especially when it comes to the care of patients. But in the classroom, and in studying, there really isn’t. The NCLEX doesn’t care if I find that question 4 is wrongly constructed, it cares that I know the correct answer. My professors don’t really care if the writing in the Fundamentals textbook is dry, boring and devoid of character, they care that I read the assigned readings and know the material they will include in the exam.

It’s hard, I admit. While there is an element of a scientific process to my thought pattern (for all that I’m an emotional softie, I’m actually a fairly logical person), it hasn’t been the primary wiring of my brain for years. I now find myself forcing new neural pathways into being and clearing the debris on old ones that have lain dormant. It is the process of creating a new mental wiring, a Nursing mental wiring.